颅内血肿粉碎针微创清除术治疗自发性丘脑出血临床疗效分析

Clinical analysis of minimally invasive evacuation of intracranial hematoma with smashing needle for spontaneous thalamic hemorrhage

目的探讨出血量在15～40ml的自发性丘脑出血患者经颅内血肿粉碎针微创清除术治疗的临床效果。方法选取2010年1月～2018年6月我院收治的条件相似的62例丘脑出血患者为研究对象,根据是否手术分为对照组和实验组各31例,对照组给予保守治疗,实验组给予颅内血肿粉碎针微创清除术治疗,分析比较两组患者的血肿清除情况、临床疗效、并发症以及神经功能缺损情况。结果实验组患者术后第1天与第3天的血肿残余量均低于对照组,差异均有明显统计学意义(P<0.05)。实验组患者术后4周(8.73±3.52)分与术后12周(5.69±1.15)分的神经功能缺损评分均明显低于对照组的(13.23±3.82)分、(7.82±2.55)分,组间差异有统计学意义(P<0.05)。实验组患者的治疗有效率(96.77%)明显高于对照组(77.41%),死亡率(3.23%)明显低于对照组(19.35%),差异均有明显统计学意义(P<0.05)。实验组患者的肺部感染、上消化道出血、压疮发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论使用颅内血肿粉碎针微创清除术对15～40ml丘脑出血患者进行治疗,能有效促进血肿清除,提高治疗有效率,减少并发症与神经功能缺损,安全性高,治疗效果确切。

Objective To investigate the clinical effect of minimally invasive removal of intracranial hematoma with a volume of15~40ml of hemorrhage in patients with spontaneous thalamic hemorrhage.Methods From January2010to June2018,62patients with thalamic hemorrhage were divided into control group and experimental group according to whether the operation was performed or not.The control group was treated conservatively and the experimental group was treated with minimally invasive debridement of intracranial hematoma.Through the comparative analysis of clinical data,two groups of patients with hematoma clearance,efficacy,complications and neurological deficits,statistical analysis.Results The residual volume of hematoma on the1st and3rd day after operation in the experimental group was significantly lower than that in the control group(P<0.05),and the neurological deficit scores at4weeks(8.73±3.52)and12weeks(5.69±1.15)after operation were significantly lower than those in the control group(13.23±3.82))and12weeks(7.82±2).The effective rate of treatment in the experimental group(96.77%)was significantly higher than that in the control group(77.41%).The mortality rate(3.23%)was significantly lower than that in the control group(19.35%).The difference was statistically significant(P<0.05).The incidence of pulmonary infection,upper gastrointestinal bleeding and pressure ulcer in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion Minimally invasive evacuation of intracranial hematoma with pulverized needle for15~40ml thalamic hemorrhage can effectively promote the evacuation of hematoma,improve the efficiency of treatment,reduce complications and neurological deficits,with high safety and obvious therapeutic effect.